MRS. COURTNEY D EDSALL (NPI# 1558830851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558830851 |
| Entity Type | Individual |
| Full Name | MRS. COURTNEY D EDSALL |
| Credential | APRN |
| Practice Address |
112 Ne Crescent Ave Peoria IL 61606-1901 |
| Practice Telephone | 3096724670 |
| Mailing Telephone | 3096724670 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.018452 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
112 NE CRESCENT AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265485973 | Heartland Home Health Care Inc. | Prosthetic/Orthotic Supplier | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2006-05-17 |
| 1265070494 | Aaron M Owens | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-12-18 |
| 1881151538 | Heather Franklin | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-02-28 |
| 1285142281 | Matthew Culp | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2018-01-12 |
| 1063936573 | Cheryl Herrmann | Clinical Nurse Specialist | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-07-27 |
| 1225566334 | Jodi Nutter | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-06-02 |
| 1063720993 | Pawan Damodhar Sarda | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2010-09-14 |
| 1053563643 | Nicholas Warnecke | Physician Assistant | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2008-10-15 |
| 1194974964 | Tahir Ilahi | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2008-09-16 |
| 1548440803 | Shahid Wazir | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2007-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1699390039 | Steven Joel Schlink | Nurse Practitioner | 12920 W Roy Rogers Rd, Peoria, AZ 85383-5334 | 2020-06-11 |
| 1457986929 | Chanelle Christine Maclin | Nurse Practitioner | 504 E Kansas St, Peoria, IL 61603-2554 | 2020-03-05 |
| 1225677495 | Michelle Chacon | Nurse Practitioner | 23201 N 87th Dr, Peoria, AZ 85383-1860 | 2020-01-05 |
| 1689218042 | Patricia Nwakaego Ayemoba | Nurse Practitioner | 16018 N 74th Dr, Peoria, AZ 85382-1810 | 2019-10-29 |
| 1144877267 | Eunice Wright | Nurse Practitioner | 26826 N 85th Dr, Peoria, AZ 85383-3624 | 2019-08-22 |
| 1861057507 | Shawnee Renee Fudurich | Nurse Practitioner | 10230 W Happy Valley Pkwy Ste 100, Peoria, AZ 85383-4255 | 2019-05-08 |
| 1265096895 | Razel Espiritu Hernandez | Nurse Practitioner | 25435 N 115th Ave, Peoria, AZ 85383-9789 | 2019-04-29 |
| 1619435310 | Jennifer Gayle Ries-clark | Nurse Practitioner | 8009 W Salter Dr, Peoria, AZ 85382-4440 | 2019-03-12 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.